Wednesday, March 25, 2015

Can Gender and Time Affect your Injury?

Knee injuries in sports have been known to be very common.Specifically anterior cruciate ligament (ACL) injuries.Males and females can suffer from knee injuries whether their sport involves or does not involve contact.Not only to athletes, but to every human, the knee is a crucial part to the human body.Obviously, without a knee there would be no way for a human to walk, run, jump or do regular every day things.Depending on the knee injury, people can be kept out of activity for several months, then has to go through rehab for even longer.

Studies have shown that males have more meniscal tears than females, which may be due to the fact that males play sports that involve a higher level of contact.After having surgery done to repair a person’s knee, that person is expected to have a more stable and more functional knee.A possible long- term risk that has been seen after ACL injuries and surgeries is osteoarthritis.Scientists are trying to find out about patients outcomes at least ten years after the ACL reconstruction was done and whether sex and graft choice will have an effect on the patient- reported outcomes.

Scientists have conducted studies that have shown that males have more meniscal tears than females, which may be due to the fact that males play sports that involve a higher level of contact, but cannot be completely proven because there are knee injuries of unknown causes, or even non- contact or non sport- related injuries.There have been three studies that analyze the outcomes depending on the sex of the patient.Barenius et al noted that there was no significant differences in KOOS based on patient sex, while Bourke et al and Labet et al also noted no significant difference based on sex, but this time in subjective IKDC scores.The data they had to collect in order to get their results included the technique, type of graft, femoral and tibial fixation, time to partial and full weight bearing, brace use and time to full activity.Scientists have also checked as to whether the graft choice would create different outcomes in patients after the repair of their ACL.

There were four studies that evaluated the impact of autograft choice on patient- reported outcomes.Barenius et al conducted a randomized control trial that once again noted no significant difference in the KOOS subscales based on graft choice.Like Barenius et al, Holm et al also noted no differences in any of the Cincinnati and Lysholm scores based on graft choice.Sajovek et al also agreed with Holm et al and lastly, Bourke et al along with the other scientists noticed no significant differences based on graft type, but in subjective IKDC scores.

Based on these results, there were generally good outcomes that were reported by the patients after ten years or more after their surgery.As stated before, the performed studies proved that sex and graft choice had no effect on the patients reported outcomes.Something that did differ by sex was predictors of comorbid intra-articular injuries. Some scientists hypothesized that predictors of intra- articular injuries and meniscal tear management would differ by sex and their findings supported this hypothesis.They were able to identify sex- specific predictors of meniscal and chondral lesions in patients that were undergoing ACL reconstruction.The data they had to collect in order to get their findings included sex, date of the injury, age at injury, body mass index (BMI), which side was injured, history of any surgeries and the type of injury.Male predictors included age, BMI, type of injury, interval from ACL injury to surgery and number of instability episodes.Whereas female predictors included only age, BMI and number of instability episodes.

People may be wondering why scientists are doing these studies and how it will benefit those with knee injuries, but what they do not realize is that finding differences that have to do with gender will allow them to do further research to hopefully treat knee injuries more effectively.Also, discovering the long term problems will also help them to fix the surgical factors that are not allowing patients to have a completely stable knee.

References:

Melissa A. Kluczynski,* MS, John M. Marzo,* MD, Michael A. Rauh,* MD, Geoffrey A. Bernas,* MD, and Leslie J. Bisson,*† MD Investigation performed at the University at Buffalo, The State University of New York, Buffalo, New York, USA (February 2015)

10 comments:

I am a little confused about the methodology involved in these experiments and what the acronyms and types of test are for, I believe this would be helpful in understanding the results of these studies and whether there is a sex difference. This is an interesting topic, one that could be applied to other types of injuries and/or surgeries as well.

Advancements in treating ACL injuries is especially important these days, especially with the rising popularity of high school athletics, where many of the participants are possibly still growing. Recognizing differences between the sexes in ACL injury is important, but as the article mentions, there are many other factors that are involved, including BMI of patient, site of injury, etc. I feel like these factors also need to be analyzed more in depth in order to obtain proper treatment of ACL injuries. Also, if difference in sex has a huge impact on the ACL, further research could be conducted regarding differences in sex and extent of injury in other areas of the body.

I would be interested to hear more about why men tend to have more ACL injuries than women- I have a hard time believing that it is because men are involved in more contact sports since many people don't play sports competitively past high school. In addition, I think research into ACL repair treatments on men and women would be more helpful than determining whether or not sex plays a role in the ACL tearing. I also had a difficult time understanding the acronyms in this article and what they stood for.

I would be interested to hear more about why men tend to have more ACL injuries than women- I have a hard time believing that it is because men are involved in more contact sports since many people don't play sports competitively past high school. In addition, I think research into ACL repair treatments on men and women would be more helpful than determining whether or not sex plays a role in the ACL tearing. I also had a difficult time understanding the acronyms in this article and what they stood for.

I agree with the comments mentioned above. I am quite unsure with the methodology and the acronyms associated with it, as it would help me grasp a better understanding of the paper. It would be more interesting to hear why the predictors for males are higher than than females. It may be true that males may play sports that have a high level of contact, but in today's modern world, you cannot always be so sure. With new scientific evidence emerging, it would also be interesting to see the additional differences rather than just this stereotypical perspective of males and females.

While some of the methodology seems a bit unclear, I think it's really intriguing how there are so many fewer predictors for lesions in ACL reconstruction for women, because I would expect results after ACL reconstruction to be dependent on many factors regardless of sex. I would expect that the same factors affect ACL reconstruction in different ways in a sex-specific manner. I am definitely interested in learning more about this because my sister tore her ACL last year and it's honestly one of my biggest fears!

The fact that one of the criteria that is being evaluated has to do with surgery is interesting to me. There have been studies done that indicate a difference in pharmacokinetic/pharmacodynamic process regarding drug metabolism, so I'm curious to know if whether it is the surgery itself that is different, or if perhaps it could be the medications/anesthesia that is utilized during the surgery and pre/post-op procedures. This study referred to by the article has the potential to lead to the maximum effectiveness of injury treatment, leading to recovery. It will be interesting to see how this research manifests itself over the next few years, especially with all of the newly focused attention on college/professional athletic injuries.

It would be great to get more information about why exactly men seem more prone to these injuries than women, however besides that it was a great post! After reading, it seems like scientific testing is leading us a step closer towards getting more personalized medicine, which as we talked about in class, is what we are gearing towards in the future!

As an athlete, ACL tears are a real everyday issue for myself and my team mates, so this topic was really interesting. However I would have liked to have the terms KOOS and IKDC explained. The results from the studies would have made more sense if I had known what these meant.